Individual provider Active NPI

Nicole Lynn Velander, AUD

  • Audiologist
  • Detroit, MI
National Provider Identifier
1124640123
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2689
Phone
(313) 916-1755
NPI assigned
May 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2689

Mailing address

25753 Livingston Cir
Farmington Hills, MI 48335-1253
Phone (308) 390-3302

Other names 1

  • Nicole Lynn Greenwalt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200925000575 MI Practitioner - Qualified Audiologist 2769805258 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Ohio State University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Wyandotte HospitalGroup PAC ID 2264334499, 194 clinicians

Practice addresses (Care Compare)

2070 Biddle Ave
Suite 3
Wyandotte, MI 48192-4080
Phone (734) 225-9187

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Wyandotte Hospital Audiologist CurrentSince Jun 24, 2020 Accepting new patients
Henry Ford Wyandotte Hospital Single Specialty Current Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Jun 24, 2020 Accepting new patients
Henry Ford Wyandotte Hospital Single Specialty Past Accepting new patients

Locations

23050 West Rd
Ste 120
Brownstown Twp, MI 48183
Phone (734) 671-1510

2070 Biddle Ave
Ste 3
Wyandotte, MI 48192
Phone (734) 225-9187

2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482

Interoperability endpoints

  • Direct secure messaging: ngreenwalt599677@direct.hfhs.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1124640123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25753 LIVINGSTON CIR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483351253",
            "telephone_number": "308-390-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022689",
            "telephone_number": "313-916-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELANDER",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "GREENWALT",
            "middle_name": "LYNN",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.